it took me a little bit, i would make sure i was listening to lung sounds as much as i could. i would get as much experience in clinicals as i could also. if you are on the job, you can ask the respiratory person to teach you too! they are a great resource.
there are a couple websites online too, dont remember where- just google it, where you can actually listen to the lung sounds too!

and crackles do not always = death

-H- RN

Dec 2, '08

As NewRN2008 said, listen to as many lung sounds as you can in clinical and get with an RT. They're an awesome resource. Shadow one for part of a clinical day if you can.

Also, know normal. That is, listen not only to your pts in clinical but also check the lung sounds on your family and friends. If you know what clear and healthy lungs sound like, then adventitious sounds will jump right out at you. If you think it's rhonchi, have the pt cough, see if that breaks up & clears the junky sounds (usually they'll hack something out too, have a tissue available or a specimen cup if needed, know what orders are outstanding)

When ascultating, start with the bases and work your way up. Those deep breaths can easily tire a pt out, esp if they're older.

There are a number of sites that have examples of lung sounds, here's a good one that also has heart sounds:

How long did it to take you to recongnize the sound of Crackles,Rhonchi or wheezing once you became a nurse?
When you hear crackles , does that mean that a patient is close to dealth?

Thanks

I learned lung sounds in my last semester of nursing school when I followed R/T for the day. You will quickly distinguish normal lung sounds from adventitious lung sounds very soon. Crackles and rhonchi are examples of sounds that can be heard in people with pneumonia......hopefully not close to death. Wheezing is heard in most COPD pts, a good deep breathe and cough can eliminate the wheezing.

I agree with above poster. Ask R/T to take you to one of his/her pts that have these type of adventitious sounds, I'm sure they won't mind.

it took me a little bit, i would make sure i was listening to lung sounds as much as i could. i would get as much experience in clinicals as i could also. if you are on the job, you can ask the respiratory person to teach you too! they are a great resource.
there are a couple websites online too, dont remember where- just google it, where you can actually listen to the lung sounds too!

trying to be friendly, not totally politically correct. lol.. esp at that time in the morning. i was actually trying to get around saying resp dood. so i wouldnt be sexist.

-H-RN
But i can take a ribbing! lol

Dec 3, '08

Crackles just means that they have fluid that has accumulated, it has nothing to do with being near death. Babies as well as children can get crackles, the other name for them is rales.

Easy way to consider things, rhonchi can be suctioned, with clearer lungs after suctioning. With crackles or rales, suctioning will not make any difference; diuretics such as lasix will.

Hope that this helps.

Dec 3, '08

RT!!! They are tremendous for help when it comes to lung stuff! Definitely get in and listen to as many lungs as you can when you are in clinicals. When I was in clinicals and we heard of a pt having crackles/rhonchi/wheezes/stridor/etc. and we weren't comofortable with it yet, then we got in there and listened (before RT had a chance to provide a breathing tx to take that sound away). Just Sunday I had a pt with a h/o CHF (not on Lasix in the hospital, but was on it at home...argh!!!) who had crackles in the bases in the AM and then developed wheezes later (had RT come look at her to give a tx, even though she needed lasix). MD still didn't dose lasix the entire shift which was charted. always document well once you know what to look for!!!!!!!!!!!!!